Securing your health insurance during and after divorce is important. Divorce brings up many administrative duties you must deal with, such as navigating Employer Insurance Plans, Medicaid, COBRA Health Insurance, and how remaining on your ex-spouse’s insurance plan will affect you.
Continue reading to learn more about health insurance after divorce and separation, how to secure your health insurance plan, and how to deal with potential challenges. As with many facets of family law, you need to know your rights and how to protect yourself.
Table of Contents
1. COBRA Health Insurance
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, provides continued group health benefits for workers and their families who have lost their benefits for various reasons, from job loss to divorce. If you divorce your spouse but share health care coverage, you will receive coverage for 36 months with COBRA.
To qualify, your ex-spouse must work at a company with at least 20 employees. To receive coverage from COBRA, you must apply within 60 days of your divorce if you want to keep the coverage you already had. You will be required to pay the policy’s full cost without any employer contributions from your ex’s employer as you may have received previously.
COBRA’s 60-day notification rule is important to note for anyone going through a divorce. You must notify your health plan administrator within 60 days of the divorce; failure to meet this deadline results in losing eligibility for COBRA coverage, which can be a significant issue for those depending on this option for continued health insurance. Address this issue in your Marital Settlement Agreement.
It is important to note that COBRA’s insurance coverage terminates after 36 months. Once COBRA terms and eligibility end, you will need to plan and take steps to ensure your health is covered, including acquiring new insurance.
2. Employer Health Insurance Plan
You should check to see if you are eligible for your employer’s health insurance plan. This plan can be way more affordable than COBRA, especially if your employer pays part of your premiums.
You usually have to wait for a specific time of the year to join employer health insurance, but losing your previous coverage due to a divorce may trigger a special enrollment period for you to enroll, depending on your employer’s plan.
3. Affordable Care Act / Obamacare Health Plan
You have two months (or 60 days) after your divorce to get coverage under the Affordable Care Act, which they refer to as a Special Enrollment Period. After these 60 days are over, you will not be able to enroll until the next open enrollment period.
Remember the following five key points when you are reviewing potential health insurance plans.
Metal Level
Obamacare divides insured people into four metal levels: bronze, silver, gold, or platinum. These levels don’t determine the quality of care but the allocation of costs in your plan.
Bronze plans are the cheapest. As monthly costs increase and the plans progress, the benefits become more comprehensive, and deductibles are lower.
Network
If you have a doctor that you would like to continue seeing, make sure they are in the company network of the plan you choose. You should be able to determine this either online or through the insurance company’s customer service phone line.
Deductible
The deductible is the amount you must spend on any medical care before the health insurance company covers your bills. You should know your policy’s deductible in case any surprise medical bills arise.
Price
Make sure you can afford your monthly payments, or your provider will cancel your health insurance plan.
Penalty
In some states, you could receive a fine if you do not have health insurance. If health insurance is required by law, you will owe the government a flat fee or a percentage of your income, whichever is greater. This nationwide requirement ended in most states in 2019.
Short-Term Health Insurance
Short-term health insurance is an affordable option for many, but it is also restrictive. You won’t be eligible if you have certain pre-existing conditions; in fact, most plans have broad exclusions for all pre-existing conditions.
Temporary insurance usually spans anywhere from up to 6 to 12 months, depending on your state of residence. But it can start as soon as the day after you apply. Some states, however, limit them to three months, and others don’t allow short-term plans at all.
Legal Situations that Can Affect Your Health Insurance after Divorce
The divorce process may not be exactly the same for everyone. Let’s review several legal scenarios and how it affects your health insurance.
What if You’re Separated but Not Divorced?
If you’re not living together, you can stay on your spouse’s insurance. One spouse usually can’t remove their partner from a health insurance plan until after the divorce is final.
If you and your spouse agree to a legal separation, the laws will vary depending on your insurance company and the state you live in. Your plan may or may not see separation as equal to divorce. You should always talk to an attorney for more information and guidance about your specific situation.
Health Insurance in a Divorce Settlement
A spouse may cover premiums for you and your children as part of the settlement, which is why you should discuss health insurance in your divorce settlement.
If You’re Divorced and Don’t Lose Your Health Insurance
If you are the primary insured party, you may not be able to choose a new health insurance plan. You might qualify to choose a new plan because someone else left your existing plan or because your household income changed, but you’ll have to confirm this with your specific insurance company.
Can a Judge Order Changes to Your Health Coverage?
A court may order one spouse to pay the other’s premiums, but it is not always mandatory.
Other FAQs
Can You Keep Your Spouse on Your Health Insurance after Divorce?
Simply put, no. There is a workaround for this, however. If spouses decide to separate, both spouses can remain on the same health insurance policy if they do not finalize a divorce and choose to legally separate instead.
What About Your Child’s Health Insurance after Divorce?
Your specific family situation, your child’s age, your state laws, and other determining factors will influence the outcome of your child’s health insurance plan. Make sure to speak with an attorney if you have any questions or concerns.
Can I Apply for Medicaid After a Divorce?
You may qualify for Medicaid Health Insurance after your divorce, depending on your income. Medicaid is a jointly-funded program at the state and federal levels that provides health insurance coverage to low-income Americans. Eligibility for this program is based on income, however, anyone can become a recipient.
You can apply for Apple Health (Medicaid in Washington State) Here.
Each state administers its own Medicaid program, including the scope of services provided. Mandatory Medicaid benefits and services in Washington State include:
- Inpatient/Outpatient Hospital Services
- Nursing Facility Services
- Home Health Services
- Physician Services
- Lab and X-Ray Services
- Family Planning
- Nurse Midwife Services
- Pediatric and Family Nurse Practitioner Services
- Birth Center Services
- Smoking Cessation Counseling For Pregnant Women
What Happens to My Health Savings Account (HSA) After Divorce?
An HSA is a health savings account that allows individuals to contribute pre-tax dollars for qualified medical expenses for themselves or their family members. HSA accounts hold monetary value and can be divided in a divorce. While an HSA is typically a reserve for medical expenses, because contributions are tax-deductible and investment gains are tax-free, the balance in these accounts can have significant value.
Regardless of what is agreed upon during divorce negotiations or ordered by a court, distributions made after the date of divorce are subject to a 20% tax. After divorce or dissolution of marriage, an individual can’t reimburse their ex-spouse’s medical expenses without paying taxes.
HSAs can be transferred between ex-spouses as part of the separation agreement, but an ex-spouse also can open their own HSA regardless of their eligibility. The new HSA is a transfer recipient from the existing HSA balance, and transferring funds between HSAs during a divorce settlement may be done without triggering tax consequences for either party.
Transferred funds can be used for qualified medical expenses in the future, for both themselves and eligible children.
What If I Am Pregnant During a Divorce?
Some spouses require emergency support during a divorce. You can file for emergency support before proceedings are finalized, which will provide you with additional financial security until a solid agreement is made between you and your ex-spouse. A divorce lawyer can help you with the paperwork and defend you in court.
Emergency support can ensure that your spouse’s insurance covering prenatal care and medical needs stays in place through the divorce. Your ex-spouse is legally required to maintain your coverage, and the courts may determine that your ex-spouse must maintain insurance coverage for you and the baby after the birth.
Final Thoughts
It is crucial that you seriously consider your health insurance options when you are in the process of a divorce. You’ll need to do a bit of research, so hiring a Washington State Bar certified divorce lawyer may help take the stress off your plate.
Many things are painful during and after a divorce – don’t let your health insurance become one of them!